A case of accidental Pyridium (phenazopyridine hydrochloride) poison ing involving a 13-month-old white girl is presented along with its se quelae of methemoglobinemia, hemolytic anemia and transient hepatocel lular toxicity. The literature has been reviewed and the pertinent aspects of the pathophysiology, signs, symptoms, tests and therapy are reported.
Get full access to this article
View all access options for this article.
References
1.
Lemberg, R. and Legge, J.W.: Hematin Compounds and Bile Pigments. New York, Interscience Publishing, Inc., 1949.
2.
Crawford, S.E. , Moon, A.E., Jr., Panos, T.C. and Hooks, C.A.: Methemoglobinemia associated with pyridium administration; report of a case. JAMA146: 24, 1951.
3.
Greenberg, M.S. and Wong, H.: Methemoglobinemia and Heinz body hemolytic anemia due to phenazopyridine hydrochloride. New Eng. J. Med.271: 431, 1964.
4.
Wander, H.J. and Pascoe, D.J.: Phenylazopyridine hydrochloride poisoning; report of a case and review of literature. Amer. J. Dis. Child.110: 105, 1965.
5.
Wendel, W.B. : Use of methylene blue in methemoglobinemia from sulfonamide poisoning. JAMA109: 1216, 1937 .
6.
Bruton, O.C. : Exchange transfusion for acute poisoning in children. U. S. Armed Forces Med. J.9: 7, 1958.
7.
MacMath, I.F. and Apley, J.: Cyanosis from absorption of marking-ink in newborn babies. Lancet2: 895, 1954.
8.
Etteldord, J.N. : Methylene blue in treatment of methemoglobinemia in premature infants caused by marking ink; 8 cases reported. J. Pediat.38: 24,1951.
9.
Stening, S.E.L. : Methemoglobinemia due to aniline. Med. J. Aust.1: 578,1951.
10.
Rieders, F. and Brieger, H.: Mechanism of poisoning from wax crayons. JAMA151: 1490, 1953.
11.
Walton, G.: Survey of literature relating to infant methemoglobinemia due to nitrate-contaminated water. Amer. J. Public Health41: 986, 1951.
12.
Ewing, M.C. and Mayon-White, R.M.: Cyanosis in infancy from nitrates in drinking water. Lancet1: 931,1951.
13.
Rosenfield, A.B. and Huston, R.: Infant methemoglobinemia in Minnesota due to nitrates in well water. Minn. Med.33: 787, 1950.
14.
Nelson, H.G. and Sanders, H.R.: Methemoglobinemia in infants due to ingestion of nitrates in well water. J. Okla. Med. Assoc.44: 232, 1951.
15.
Fawns, H.T. and Aldridge, A.G.W.: Methemoglobinemia due to nitrates and nitrites in drinking water. Brit. Med. J.2: 575, 1954.
16.
Oregeran, J.D. , Martin, M.D., Caraway, C.T., Martine, R.M. and Hauser, G.H.: Methemoglobinemia from eating meat with high nitrate content. Pub. Health Rep.72: 189, 1957.
17.
Tepperman, J., Marquardt, R., Reifenstein, G.H. and Fozner, E.L.: Methemoglobinemic cyanosis: report of an epidemic due to extract substituted for maple syrup. JAMA146: 923, 1951.
18.
Wolff, J.A. : Methemoglobinemia due to benzocaine. Pediatrics20: 340, 1958.
19.
Goluloff, N. : Methemoglobinemia due to benzocaine. Ibid.21: 340, 1958.
20.
Zeitoun, M.M. : Nitrobenzene poisoning in infants due to inunction with false bitter almond oil. J. Trop. Pediat.5: 73, 1959.
21.
Hansen, J.E. , Cleve, E.A. and Pruitt, F.W.: Relapse of vivax malaria treated with primaquine and report of one case of cyanosis methemoglobinemia due to primaquine. Amer. J. Med. Sci.
22.
Finch, E. and Lorber, J.: Methemoglobinemia in newborn probably due to phenytoin excreted in human milk . J. Obst. Gynaec. Brit. Comm.61: 833, 1954.
23.
Claps, F.X. : Two cases of methemoglobinemia and acute hemolytic anemia with death following the ingestion of a solution of para-amino-salicylic acid. Amer. Rev. Tuberc.76: 862, 1957.
24.
Deas, T.C.: Severe methemoglobinemia following dental extractions under lidocaine anesthesis . Anesthesiology17: 204, 1956.
25.
Shirkey, H.C.; Pediatric Therapy, ed. 3. St. Louis, C. V. Mosby Company, 1968 .
26.
Cooke, R.E. and Levin, S.: The Biologic Basis of Pediatric Practice. New York, McGraw-Hill Book Company, 1968.
27.
Goodman, L.S. and Gilman, A.: The Pharmacological Basis of Therapeutics, ed. 3. New York, The Macmillan Company , 1965.
28.
Nelson, W.E., Vaughan, V.C., III and McKay, R.J.: Textbook ofPediatrics, ed. 9. Philadelphia, W. B. Saunders Company , 1969.
